The public health flip flop on face Masks; Let's not politicize science and courtesy

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Agatha Farmer

Last week we posted a contributed column from a Muskoka business owner who would like to see face masks become a mandatory accessory during Covid-19. The column gathered a multitude of comments both agreeing and disagreeing with the suggestion. Those who strongly opposed the no mask, no service model expressed that they would not support any business with such a policy.

It seems, however, that the confusion regarding public opinion on face masks stems from the initial recommendations at the outset of the pandemic from both the World Health Organization as well as the CDC which advised against wearing masks, saying there was little evidence that it would help prevent people from getting sick. That recommendation later flipped flopped as studies began to show evidence that asymptotic carriers might be spreading Covid-19. Today, both organizations encourage all people in public to wear masks, including cloth-based coverings, to prevent the virus from spreading.

Dr. Megan Ranney, a Rhode Island Hospital ER physician in an interview with CNBC pointed out that the reversal in opinions regarding face masks is “part of the process” and that leading public health authorities would adapt their thinking based on new information. 

Carl Bergstrom, a biology professor of the University of Washington explained that very little was known about the virus back in January and February. So infectious disease specialists and epidemiologists had to do their best without much data at their fingertips.

“When you take a completely novel virus, you are starting out from a position of by default knowing nothing,” Dr. Bergstrom explained. “You can at best make guesses based on what you know about previous coronaviruses and prior outbreaks of other respiratory viruses.

As a pandemic progresses, scientists will get more data as more cases occur. That gives us more time to do basic investigation into the molecular biology of the virus and the interaction between the virus and host. You get more opportunity to watch how transmission works. And you come up with new conclusions based on more evidence, and then you make those public because it’s the best of what you know.”

Canada's top doctor and public health official Dr. Theresa Tam also flipped flopped on the issue. Early in the lockdown Tam was not recommending face masks for anyone outside of the health care field. However, as science on masks began evolving as well as the understanding of asymptomatic Covid-19 spreaders, public health measures and recommendations based on studies and reports began to shift as well. The mask change of mind by all public health officials can be attributed to Bergstrom's theory. It wasn't until March that consistent studies were showing patterns of asymptomatic transmission and unfortunately large scale public health measures can't be implemented based on one case reports.

This since evolution is consistent with Tam's April statement when she said that "a non-medical mask can reduce the chance of respiratory droplets coming into contact with others or landing on surfaces." She has, however, also noted that "science is not certain but we need to do everything that we can, and it seems a sensible thing to do."

Wearing a mask or not is not a political statement, scientists and doctors are but mere humans and have a limited understanding of new diseases until they are studied and results are available for conclusions which then build recommendations. In 2020 wearing a mask might save a life and why would that not be a priority for mankind? However, it is also a courtesy gesture for other humans who might still be afraid of the unknown. Be Kind and keep an open mind when you are reviewing the below face mask facts and information from public health sources.

Public Health Ontario has the following info regarding masks:

- Wearing a mask can help to prevent the spread of some respiratory illnesses, but it can also become a source of infection if not worn or discarded properly. If you need to wear a mask, you should also be sure to clean your hands frequently with soap and water or alcohol - based hand sanitizer .

- Unless you have symptoms of COVID - 19, there is no clear evidence that wearing a mask will protect you from the virus, however wearing a mask may help protect others around you if you are sick.

Government of Canada:

- When worn properly, a person wearing a non-medical mask or face covering can reduce the spread of his or her own infectious respiratory droplets.

- Homemade masks are not medical devices and are not regulated like medical masks and respirators. Their use poses a number of limitations:

  • they have not been tested to recognized standards

  • the fabrics are not the same as used in surgical masks or respirators

  • the edges are not designed to form a seal around the nose and mouth

  • they may not provide complete protection against virus-sized particles

  • they can be difficult to breathe through and can prevent you from getting the required amount of oxygen needed by your body

- These types of masks may not be effective in blocking virus particles that may be transmitted by coughing, sneezing or certain medical procedures. They do not provide complete protection from virus particles because of a potential loose fit and the materials used.

- Medical masks, including surgical, medical procedure face masks and respirators (like N95 masks), must be kept for health care workers and others providing direct care to COVID-19 patients.

Centre for Disease Control:

- Cloth face coverings provide an extra layer to help prevent the respiratory droplets from traveling in the air and onto other people.

- CDC is additionally advising the use of simple cloth face coverings to slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others.  Cloth face coverings fashioned from household items or made at home from common materials at low cost can be used as an additional, voluntary public health measure.

-The cloth face coverings recommended are not surgical masks or N-95 respirators.  Those are critical supplies that must continue to be reserved for healthcare workers and other medical first responders, as recommended by current CDC guidance.

The CDC has also advised who should not be wearing a mask:

- Children under age 2

· Anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the mask without assistance.

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